Intubation Ergonomics and Effectiveness using Aerosol Box

Abstract

The pandemic COVID-19 has caused a rupture and disturbance in many ecosystems, especially in healthcare.  Although previously patients were treated and given first-hand treatment especially during life threatening event, currently, the safety of healthcare workers have also become the utmost priority.  Due to the nature of COVID-19 virus that is able to spread easily via respiratory droplets and aerosols, using mouth and eyes as the route of entry, healthcare workers need to protect themselves while saving the patients at the same time. Therefore, the most common lifesaving procedure at accident and emergency department was chosen, i.e. the intubation procedure. The aerosol box is introduced and used widely during the intubation procedure, especially in accident and emergency department.  The study has three objectives. First, to determine whether the aerosol box can provide protection to its users, secondly to suggest an improvement based on the current design of the aerosol box and thirdly to determine the risk of musculoskeletal injuries among healthcare workers using Rapid Entire Body Assessment (REBA). In this study, direct observation was made during the assessment before suggesting the required recommendation on how to improve the existing aerosol box. The first objective was achieved by conducting a direct observation when participants were conducting the intubation procedure. Any possibility of participants getting exposed to the risk of COVID-19 due to the failure of the box in guarding, was noted by the observer. Recommendation for improvement was made based on these findings, and served the second objective of the study. To achieve the third objective, ergonomics assessment using Rapid Entire Body Assessment (REBA) was conducted. REBA scores represent the severity of musculoskeletal risk imposed to healthcare workers during intubation procedure. Two participants took part in the study voluntarily. Results showed that the aerosol box used in this study does not protect healthcare workers from COVID-19. The current design of aerosol box used must be improvised in order to increase its effectiveness.  As for body postures, REBA scores were between medium and high, thus it required immediate corrective actions. With modification, the aerosol box may better protect healthcare workers from being exposed to the COVID-19 virus.